DennisBeaverFebruary 8, 2019 • By Dennis Beaver

Today’s story will be of special interest to two groups of readers who are linked together by what is known as a lien, which I’ll explain in a moment. They are:

(1) People who were injured in an auto accident who lack good health insurance or adequate amounts of auto medical payments coverage but need treatment from a chiropractor, MD or physical therapist. They hire an attorney to file an insurance claim against the responsible party.

(2) Chiropractors, MD’s or physical therapists who provide treatment, and, as Los Angeles based attorney Shawn Steel adds, “Contractually–on a lien basis–agreeing to wait for payment of their services when the case is settled.”

An Enforceable Contract

Specializing in personal injury cases and representing chiropractors for over 35 years, Steel explains that a lien, “Is a binding, enforceable, written contract signed by the patient, attorney and health care provider requiring bills to be paid from the proceeds of settlement prior to the individual receiving any funds.”

But he was quick to point out, “That’s how it is supposed to work – it is what the law requires, but in my experience, over 3/4 of lawyers who handle personal cases on a lien basis flagrantly refuse to honor the lien and far too many health care professionals just don’t know what to do when they are stiffed, or their bill is cut to shreds.”

The recent example of our client, “Dr. S” is typical.

“My Polite Requests to Pay Our Bill was Ignored!”

I have a soft spot in my heart for chiropractors and respect their abilities. Years ago, a chiropractor delivered me from the worst and most painful stiff neck imaginable. I became a believer and we referred our auto accident clients to him for years, always receiving positive feedback. So, when a chiropractor is badly dealt with by a lawyer, I take that personally and that’s what happened to Dr. S.

His lien was signed by both a local attorney and the patient, but when the case was settled the lawyer refused to payment of the chiropractor’s bill. “We placed call after call to the lawyer’s office and did not even receive the courtesy of a return phone call,” Dr. S. explained, not only frustrated, but hurt.

I phoned my colleague and gave him 48 hours to have a check delivered to the chiro’s office or find himself in court.

Needless to say, the bill was paid at once–in full. But this should not have dragged on for so long, and that is Steel’s message to all health care providers who treat on a lien basis. “Understand your rights and the attorney’s legal obligation,” he underscores.

The Lawyer Is a Fiduciary – Do Not Let anyone Browbeat You Down!

“In all 50 states, the Doctor’s Lien, or Letter of Protection as it is also called in some states, creates a fiduciary relationship making the lawyer trustee of settlement funds for the benefit of the client, the doctor and, finally, the attorney.

“I find repeatedly lawyers insisting that the doctor cut his bill, but the attorney refuses to reduce his when the settlement is not as high as was expected – or that is what the lawyer tells the doctor. In the typical case this is inherently unfair, as the doctor has spent weeks or months in treating the patient, while the lawyer perhaps saw the client once and made two phone calls.

“There is nothing wrong with everyone taking a little less than full payment if the money just isn’t there, but I urge my doctor clients to stand up to strong arm tactics by going through these steps:

–When you get a phone call asking that you cut your bill, ‘Because the settlement was too low and I can only get you $1,000,’reply by stating, “Please send me a copy of the draft, settlement agreement and client’s proposed disbursement.”
“Remember, a lawyer can easily lie on the phone, but will hesitate to do so in writing. You have the legal right to see all of those documents and how funds are to be distributed.”

If that information is not provided, then, Steel recommends:

–Send a demand letter to the lawyer with a 7 day deadline. Attach the lien, your report and bill. In your letter state, ‘I am sure you are familiar with the Rules of Professional Conduct.’

–On the 8th day, file a complaint with the State Bar, send the attorney a copy of it and file your suit in Small Claims Court.

“You will get paid – and, if it goes to court, judges almost always rule in favor of the doctor,” Steel concludes. Shawnsteel.com is his website which I highly recommend.


Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.



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